Validation of a Novel Radiographic View for Evaluating Proximal Humerus Fractures: The Clear View

Background: Orthogonal radiographs of the proximal humerus are challenging to obtain because patient’s body mass can impede a quality lateral view and positioning shoulder cause fracture displacement patient discomfort. We describe novel radiograph, clear (CL), taken 90° scapular Y (SY), developed with goal minimize pain reduce radiation exposure. Evaluate ability accurately evaluate utilizing CL in comparison standard available x-rays assess score when obtaining CL. Methods: Eleven independent observers at different levels experience evaluated angulation translation three fractures: two cadaveric fractures third 15-year-old determine intra-observer correlation (ICC). Each underwent traditional radiographic series anteroposterior (AP) internal rotation (IR), AP external (ER), true axillary (AX), SY, transthoracic (TRANS) plus computed tomography (CT). was obtained on cadaver fractures. Pain scores based Wong-Baker FACES Scale were assessed for individual projections thirteen patients Results: ICC >0.6 all measures. True underestimated majority (>75%) time views, TRANS (p<0.001) AX (p<0.049) views had least amount error. Moreover, measures both overestimated but most accurate IR, ER, views. ranged from 0-1.2 obtained. Conclusions: Our study demonstrates that is often difficult measure regardless utilized. However, view, combined offers an orthogonal, reproducible, valid causes minimal